Lumbar Stabilization, Strengthening and Stretching in Chronic Low Back Pain
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Purpose
The purpose of this study was to compare the efficacy of three exercise programs in patients with chronic low back pain: Segmental stabilization, superficial strengthening and stretching. Groups were contrasted regarding pain, functional disability and TrA muscle activation capacity. The three groups of exercise improved pain and functional disabilities, and the Segmental stabilization group was better in the ability to recruit TrA muscle.
| Condition | Intervention |
|---|---|
|
Chronic Low Back Pain |
Other: Stabilization , strengthening and stretching |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Treatment |
| Official Title: | Lumbar Segmental Stabilization, Strengthening and Stretching in Chronic Low Back Pain: a Comparative Study |
- Pain (visual analogical scale and McGill pain questionnaire) [ Time Frame: Six weeks ] [ Designated as safety issue: Yes ]
- Functional disability (Oswestry disability questionnaire) [ Time Frame: Six weeks ] [ Designated as safety issue: Yes ]
- TrA muscle activation capacity (Pressure Biofeedback Unit = PBU) [ Time Frame: Six weeks ] [ Designated as safety issue: Yes ]
| Enrollment: | 45 |
| Study Start Date: | February 2007 |
| Study Completion Date: | June 2009 |
| Primary Completion Date: | March 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Stabilization group
In the Segmental Stabilization group exercises focused on the transversus abdominis and lumbar multifidus muscles.
|
Other: Stabilization , strengthening and stretching
Interventions were conducted over 6 weeks, twice per week, lasting 30 minutes each. Sessions were supervised by the investigator, and participants were instructed to report any adverse event. Groups were instructed not to participate in any other physical program during the study. Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles). Patients were evaluated for pain , functional disability,and ability to contract the TrA before and after the treatment.
Other Name: Pressure Biofeedback Unit
|
|
Experimental: Strengthening group
In the Superficial Strengthening group, exercises focused on the rectus abdominis, abdominus obliquus internus, abdominus obliquus externus and erector spinae muscles.
|
Other: Stabilization , strengthening and stretching
Interventions were conducted over 6 weeks, twice per week, lasting 30 minutes each. Sessions were supervised by the investigator, and participants were instructed to report any adverse event. Groups were instructed not to participate in any other physical program during the study. Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles). Patients were evaluated for pain , functional disability,and ability to contract the TrA before and after the treatment.
Other Name: Pressure Biofeedback Unit
|
|
Experimental: Stretching group
Stretching group: erector spinae, posterior connective tissues and ischiotibials muscles
|
Other: Stabilization , strengthening and stretching
Interventions were conducted over 6 weeks, twice per week, lasting 30 minutes each. Sessions were supervised by the investigator, and participants were instructed to report any adverse event. Groups were instructed not to participate in any other physical program during the study. Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles). Patients were evaluated for pain , functional disability,and ability to contract the TrA before and after the treatment.
Other Name: Pressure Biofeedback Unit
|
Detailed Description:
Objective: To contrast the efficacy of three exercise programs, segmental stabilization and strengthening of abdominal and trunk muscle and lumbar stretching on pain, functional impairment, and activation of the transversus abdominis muscle (TrA), in individuals with chronic low back pain.
Design: Forty-five patients were randomized into three groups namely: Segmental stabilization group (ES)(transversus abdominis and lumbar multifidus) (n=15, mean age 42,02 ± 8,15), superficial strengthening group (FS)(rectus abdominis, oblique abdominal muscles and erector spinae muscles) (n=15, mean age 41,71±6,41) and stretching group (AL) (erector spinae, posterior connective tissues and ischiotibials muscles) (n=15 mean age 41,53 ± 4,41). Groups were contrasted regarding pain (visual analogical scale and McGill pain questionnaire), functional disability (Oswestry disability questionnaire) and TrA muscle activation capacity (Pressure Biofeedback Unit = PBU). The program lasted 6 weeks, and sessions happened twice a week, with duration of 30 minutes each. Analysis of variance was used for inter and intragroup comparisons. Significance level was established at 5%.
Patients attended two weekly sessions during six weeks and were evaluated for pain (visual analogue scale and McGill Pain Questionnaire), functional disability (Oswestry disability index), and ability to contract the TrA (Pressure biofeedback unit) before and after the treatment. The treatment program consisted of 30 minutes sessions. The Anova one-way and Tukey´s Post Hoc were used to compare groups. The significance level adopted was 5%.
Eligibility| Ages Eligible for Study: | 23 Years to 53 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- low back pain for more than 3 months
- patients willing to participate and could participate in an exercise program safely and without cognitive impairments that would limit their participation.
Exclusion Criteria:
- past history of back surgery
- rheumatologic disorders
- spine infections
- spine exercise training in the 3 months before study onset.
Contacts and Locations| Brazil | |
| University of Sao Paulo General Hospital | |
| Sao Paulo, Brazil | |
| Principal Investigator: | Fabio R França, MSc | University of Sao Paulo |
More Information
Additional Information:
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Fábio Jorge Renovato França, University of Sao Paulo General Hospital |
| ClinicalTrials.gov Identifier: | NCT01124201 History of Changes |
| Other Study ID Numbers: | 1249/06 |
| Study First Received: | May 13, 2010 |
| Last Updated: | May 13, 2010 |
| Health Authority: | Brazil: National Committee of Ethics in Research |
Keywords provided by University of Sao Paulo General Hospital:
|
low back pain clinical trial stabilization muscle stretching exercises exercise therapy |
Additional relevant MeSH terms:
|
Back Pain Low Back Pain Pain |
Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on May 16, 2013